The Affordable Care Act (ACA) requires companies with 50 or more full-time employees to provide affordable health care coverage or pay a penalty. It defines a full-time employee as someone who works 30 or more hours per week. To be compliant, a company's health plan must cover at least 60% of medical costs and not cost employees more than 9.5% of their income. Companies must file 1094-C and 1095-C forms with the IRS by May or June and January, respectively, to report their compliance and coverage offered to employees. Sections 6055 and 6056 outline ACA reporting requirements.
2. The Affordable Care Act was created to help ensure
all people have affordable healthcare options.
And to give uncles
everywhere something
to gripe about.
Like it or not, your company has to be ACA compliant.
And even though we aren’t ACA consultants, we are
employee data experts so we’re here to answer a few
questions to make filing easier.
3. DoesACAapplytomysmallcompany?
IF YOUR COMPANY HAD THEN YOU NEED TO
50 or more full-time
employees (or full-time
equivalents) in 2014
Comply with ACA requirements
(However, companies that had
between 50 and 99 employees in
2014 will not have to pay penalties.)
Have been ACA-compliant for
2015 and file the appropriate
tax forms in 2016 to prove that
they were compliant
More than 100
employees in 2014
4. Whatisconsideredfull-timeforemployees?
The IRS considers any employee who works an average of 30 or
more hours per week (or 130 hours each month) full-time. Keep
in mind that part-time employees’ hours DO factor into how
many full-time employees (or equivalents) you have. If you’re not
sure how to determine the number, you can use this calculator
to find out.
5. IfIofferhealth-carecoveragetoemployees,
amIACAcompliant?
Not necessarily. The following guidelines must apply to make sure the health
coverage you offer is compliant:
1. Health coverage must provide a certain level of value. An ACA-compliant
health plan needs to cover at least 60 percent of the total cost of an
employee’s medical expenses. This should also include hospital and
physician benefits.
2. Health coverage must be affordable. The coverage you provide can’t cost
employees more than 9.5 percent of their annual household income for
an individual plan.
3. However, some safe harbors exist in case you don’t know all your
employees’ household incomes. For more information on how to
calculate affordability, go here.
7. 1094-C:
The form you file with the IRS that shows your company’s health-
care coverage is ACA-compliant. It must be sent to the IRS by the
end of May (for companies with fewer than 250 eligible employees)
or June (if filed electronically for companies with more than 250
eligible employees). This form gives information about:
• your company’s contact and tax information
• your ACA tracking and reporting strategy (including if you’re
using any Safe Harbors)
• how many full-time employees you had during the year and
if they were offered qualifying coverage
For more extensive instructions about the 1094-C, visit the IRS web page.
8. 1095-C:
the form you need to provide all full-time employees by January
31, 2016. You also must send these 1095-Cs to the IRS by the end of
March. This form includes information about:
• the type of health coverage offered and who it was offered to
• the percentage of the premium the employee would have
paid if they had employee-only coverage
• enrollment, employment status, and if certain Safe Harbors
were used to calculate affordability
For more extensive instructions about the 1095-C, visit the IRS web page.
10. WhydoIkeephearingaboutSections
6055and6056?
Sections 6055 and 6056 outline the reporting requirements
companies must comply with that were created by the Affordable
Care Act (ACA). Section 6055 applies to companies that have
employees who are self-insured, while section 6056 applies to
companies with at least 50 full-time employees.
These reporting rules help companies know which information
they need to report to the IRS and the health coverage they offer to
employees. You can review more details of sections 6055 and 6056
on the IRS website.
11. Whatis“transitionrelief”anddoesmycompanyqualify?
According to Section 4980H or Safe Harbor, companies who had 50-99
employees in 2014 may not be subjected to penalties in 2016 if they
• average 50-99 full-time employees
• don’t cut their workforce with the intent to qualify for “transition relief”
• and their health coverage is maintained until the end of the year.
In addition, Safe Harbor includes alternative methods of tracking your health
plan’s affordability, your employees’ employment status, and enrollment for
individual employees.
12. WhatisthepenaltyifmycompanyisnotACA-compliant?
DoesACAapplytomysmallcompany?
IF YOU DO NOT THEN YOU MUST PAY
offer health coverage at all
$2000 for every full-time employee excluding
the first 30 employees
$3000 for every full-time employee excluding
the first 30 employees
$200 for each missing form not received
by the IRS
$200 for each statement that should have
been received
offer “affordable” health
coverage
file the appropriate forms
provide employees with
the written statement
The IRS will charge a penalty based on how many employees you have. (Although
if you had fewer than 100 employees in 2015, penalties will not apply until 2016.)
In addition, each of your employees may be fined if they are not covered with proper health insurance.
13. BambooHR can help you manage and report on some of the ACA information you need to be
compliant (and sane). Give us a call at 1-866-387-9595 or click below to see how we can help.
Informationoverload?Nosweat.
SOURCES:
http://www.irs.gov/instructions/i109495c/ar01.html#d0e296
http://www.irs.gov/pub/irs-pdf/p5196.pdf
http://www.irs.gov/Affordable-Care-Act/Employers/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act#Identification
CLICK HERE FOR A FREE TRIAL